Provider Demographics
NPI:1720389554
Name:HABEEB LAKHANI MD PA
Entity Type:Organization
Organization Name:HABEEB LAKHANI MD PA
Other - Org Name:SAWGRASS FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HABEEB
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:LAKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-442-3400
Mailing Address - Street 1:10031 PINES BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6195
Mailing Address - Country:US
Mailing Address - Phone:954-442-3400
Mailing Address - Fax:954-442-0310
Practice Address - Street 1:7604 NW 186TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2929
Practice Address - Country:US
Practice Address - Phone:305-362-8182
Practice Address - Fax:305-826-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047935261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016619500Medicaid
FL043012900Medicaid
FLD64963Medicare UPIN